Objective:To study the alteration of K-ras mutations in different stages of colorectal cancer(CRC) and its influence on the progression of CRC. Methods:The 20 paraffin-embedded tissues, including primary foci, metastatic lymph nodes, remoter metastatic foci, colorectal adenoma, and normal colorectal tissues, were collected from 20 patients with colorectal cancer. The sequence of PCR-amplified products were analyzed. Results:The wild K-ras gene was expressed in normal colorectal tissues. The mutation frequency of K-ras gene was 20.0% (4/20) in colorectal adenoma, 30.0% (6/20) in primary foci, 25.0% (5/20) in metastatic lymph nodes, and 30% (6/20) in remote metastatic lesions. In the samples with K-ras mutations, the consistency of the types of K-ras mutations between primary foci and colorectal carcinoma, lymph node metastatic lesions, remote metastatic lesions was 0.0%(0/4), 40.0%(2/5), and 50.0%(3/6), respectively.Conclusion:The colorectal adenoma, metastatic lymph nodes and remote metastatic lesions were not suited for K-ras analysis as routine samples in clinical practice. If the samples of primary lesions were not available, the detection results of metastatic lymph nodes and remote metastatic remote lesions will provide some reference values. K-ras gene had several different mutations in the progression of CRC.

Objective To establish normal reference ranges for serum cystatin C (Cys C)in relatively healthy middle-aged and elderly(＞50 years)Chinese individuals.Methods A total of 1087 candidates were consecutively selected and serum Cys-C levels were measured by transmission turbidimetry.Frequency analysis and histogram were used to establish the 95％ confidence reference range according to methods provided by CLSI (C28-A2).Results Based on the definition and verification procedures for clinical laboratory reference ranges(CLSI C28-A2,second edition),Cys-C levels of 1087 participants fell within the range of 0.30-1.55 mg/L;Male participants had higher serum Cys-C levels than female participants(Z=-10.19,P＜0.01).The serum Cys-C level increased with age,regardless of gender(R =0.600,P＜ 0.01).Differences in Cys-C levels between age groups were statistically significant (x2=411.17,P＜ 0.01).The reference ranges of normal serum Cys-C levels for different age groups (50-,55-,60-,65-,70-,75-,) were 0.42-0.98mg/L,0.45-1.04mg/L,0.47-1.34mg/L,0.46-1.38mg/L,0.61-1.33mg/L,0.61-1.28 mg/L,respectively,for males,and 0.39-0.94mg/L,0.42-1.01mg/L,0.40-0.91mg/L,0.46-1.03mg/L,0.57-1.04mg/L,0.55-1.27mg/L,respectively,for females.Conclusions This study established preliminary normal serum Cys-C reference ranges for healthy middle-aged and elderly(＞ 50 years)individuals in this region,which can serve as parameters for disease diagnosis and treatment evaluation.

Objective To analyze the epidemud growth factor receptor(EGFR)mutations in NSCLC patients in Fujian province.Methods Fresh specimens of lung cancer and corresponding normal lung tissue were collected from 50 cases of NSCLC patients.After DNA extraction,nested polymerase chain reaction (nested PCR)and direct deoxyribonucleic acid(DNA)sequencing were used to analyze EGFR gene mutations in NSCLC patients.Results EGFR mutations in tumors were identified from 13 of 50(26%)patients,including 10 cages of in-frame deletion in exon 19 and 3 cases of amino acid substitution in exon 21.Conclusion The mjor type of EGFR mutation in NSCLC patients in Fujian is in-frame deletion in exon 19.

Objective To investigate the advantages of detection for EGFR gene mutations by denaturing high performance liquid chromatography (DHPLC) technology. Methods DHPLC was used to detect EGFR gene mutations at exon 19 and 21 in 49 cases of non-small cell lung cancer (NSCLC) patients,and the direct DNA sequencing was used to verify the accuracy of DHPLC detection. Results EGFR gene mutation was identified from 13 of 49 cases by DHPLC,including deletion mutation at exon 19 in 10 cases (76.92 %) and alternative mutations at exon 21 in 3 cases (23.08 %). Mutation results of DHPLC was consistent with DNA direct sequencing. The results of the direct DNA sequencing were the same as those of DHPLC. The sensitivity of mutation test by DHPLC was 100 %. Conclusion DHPLC technology can be used for large scale screening of EGFR gene mutation with rapid and accuracy.

Objective To study the clinical effect of mouse nerve growth factor in the treatment of patients with traumatic facial nerve injury .Methods From April 2015 to October 2017,60 patients with traumatic facial nerve injury in the People's Hospital of Sanmen County were selected and divided into observation group and control group by completely random assignment method ,with 30 cases in each group.All patients were given dexamethasone ,sodium aescinate and nimodipine treatment ,on this basis,the control group was given mecobalamin treatment ,the observation group was given mouse nerve growth factor treatment .The changes of facial nerve function before treatment were assessed,and the clinical efficacy was compared between the two groups .Results After treatment,the facial nerve function grade in the observation group (Ⅰ18 cases,Ⅱ8 cases,Ⅲ2 cases,Ⅳ0 case,Ⅴ1 case,Ⅵ1 case) was significantly better than those in the control group (Ⅰ 6 cases,Ⅱ4 cases,Ⅲ5 cases,Ⅳ8 cases,Ⅴ4 cases,Ⅵ3 cases),the difference was statistically significant (χ2＝12.87,P＜0.01).The total effective rate of the observation group was 93.33%,which was significantly higher than 70.00% of the control group,the difference was statistically significant (χ2＝7.81,P＜0.05).Conclusion Mouse nerve growth factor in the treatment of patients with traumatic facial nerve injury has important clinical value ,it is helpful to alleviate the clinical symptoms ,improve facial nerve function and clinical cure rate ,it is worthy of clinical application .

Objective To evaluate the effects of simulation training based on the concept of experiential education on im-proving first aid skills of medical staff in nursing homes.Methods The assessment data of 120 medical staff participating in first aid simulation training in our nursing home from January 2020 to June 2023 were retrospectively analyzed.Using a self-controlled design,the changes in skills operation,reaction time,team cooperation,etc.were statistically analyzed.Results All indicators were significantly improved after training.The skill operation score increased by 12.4 points(P＜0.05),the average reaction time decreased by 5.2 seconds(P＜0.05),and the team cooperation score increased by 13.8 points(P＜0.05)compared with before training.Conclusion Simulation training based on the experiential education model can effectively improve the first aid skills and cooperation ability of medical staff,which is an important means to continuously improve the emergency response capac-ity in nursing homes.